Abstract
BackgroundBlood loss from the gastrointestinal tract can be an acute and life-threatening event. For the treatment of gastrointestinal bleeding, it is important to accurately detect gastrointestinal bleeding and to localize the sites of bleeding. The purpose of this study was to retrospectively assess the capabilities of SPECT/CT in the diagnosis of gastrointestinal bleeding by a comparison with planar imaging alone as well as planar and SPECT.MethodsWe conducted a retrospective analysis of 20 patients (21 examinations) who underwent gastrointestinal bleeding scintigraphy in the past 7 years and in whom the bleeding site was identified by endoscopy or capsule endoscopy, or in whom no evidence of gastrointestinal bleeding was identified during the clinical course. Five patients (5 examinations) were diagnosed by planar imaging (planar group). Eight patients (9 examinations) were diagnosed by planar imaging and SPECT (planar + SPECT group). Seven patients (7 examinations) were diagnosed by planar imaging and SPECT/CT (planar + SPECT/CT group). We calculated the diagnostic ability of each method in detecting the presence of bleeding, as well as the ability of each method to identify the sites of bleeding. The sensitivity, specificity, and accuracy of the methods were compared.ResultsThe diagnostic ability of the three imaging methods in detecting the presence of gastrointestinal bleeding was as follows. Planar imaging showed 100% sensitivity (3/3), 100% specificity (2/2), and 100% accuracy (5/5). Planar + SPECT imaging showed 85.7% sensitivity (6/7), 100% specificity (2/2), and 88.9% accuracy (8/9). Planar + SPECT/CT imaging showed 100% sensitivity (6/6), 100% specificity (1/1), and 100% accuracy (7/7). The diagnostic ability of the three modalities in detecting the site of bleeding was as follows: planar, 33.3% (1/3); planar + SPECT, 71.4% (5/7); and planar + SPECT/CT, 100% (6/6).ConclusionsAll 3 imaging methods showed good accuracy in detecting the presence of gastrointestinal bleeding. The addition of SPECT or SPECT/CT made the anatomical position of the uptake clear and contributed to the localization of the site of gastrointestinal bleeding. Planar + SPECT/CT imaging therefore showed the highest diagnostic ability for detecting the site of gastrointestinal bleeding.
Highlights
Blood loss from the gastrointestinal tract can be an acute and life-threatening event
Patients Twenty patients who underwent a total of 21 scintigraphic examinations because of gastrointestinal bleeding over the 9-year period from March 2007 to September 2015 were retrospectively included in the study
The bleeding site was identified by endoscopy (n = 11), capsule endoscopy (n = 2) or contrast-enhanced computed tomography (CT) (n = 2), or else no evidence of gastrointestinal bleeding was identified during the clinical course (n = 5)
Summary
Blood loss from the gastrointestinal tract can be an acute and life-threatening event. In most cases, bleeding will stop spontaneously without any intervention; blood loss from the gastrointestinal tract can represent an acute and life-threatening event. Angiography has the advantage of therapeutic intervention through transcatheter embolization, but cannot detect bleeding at a rate of < 1.0 ml/min [3, 4]. Intermittent bleeding is difficult to detect by angiography [5]. The accuracy of the angiography in detecting the site of bleeding is reported to range from 43 to 87% [6, 7]. Contrast enhanced CT is used to detect gastrointestinal bleeding. In a study using a swine model, a colonic bleeding rate of 0.3 ml/min was detectable on contrast enhanced CT [9]. Capsule endoscopy revolutionized the examination of the small intestine, and has been established as one of the procedures used to diagnose small intestine bleeding [10, 11]; the diagnostic yield is 40– 60% [12, 13]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
